General Questions
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Surgery Questions
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Life After Surgery
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Nutrition, Food & Eating After Surgery
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General Questions
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- What is Body Mass Index?
It is an estimate of your total body fat. BMI is calculated by dividing your weight
(in kilograms) by the square of your height (in meters).
For eg: A 100kg person who is 1.7 meters tall would have a BMI of 100/1.7x 1.7=
58.8/1.7=BMI 34.6
- How is obesity defined?
According to the National Institutes of Health, anyone with a Body Mass Index of
25 (BMI) or above is considered overweight. A BMI of 30 or higher indicates obesity.
- What are the primary risks related to or associated with obesity?
According to the CDC, obesity-related risks include three diseases that are the
leading killers of Indians: heart disease, cancer, and cerebrovascular conditions,
including stroke. Obesity also contributes to diabetes, the sixth-leading cause
of death in India. In addition, occurrences of sleep apnea – known as the silent
killer – significantly increase with excess weight.
- What is B-lite Clinic?
‘B-lite Clinic' is Mumbai’s premier weight management clinic, where highly skilled
and experienced bariatric surgeons, dietitians, bariatricians, psychologists, and
exercise psychologists, along with a team of licensed, certified healthcare professionals,
provide surgical and non-surgical treatment for the disease of obesity. At ‘B-lite
Clinic’, we have literally treated thousands of individuals struggling with their
weight, just like you. Our team is dedicated to providing you with the most effective
medically-supervised treatments for obesity and weight management available today.
We perform laparoscopic adjustable gastric banding (LAGB), via the LAP-BAND® System
and the REALIZE Band™. In addition, we perform gastric bypass, sleeve gastrectomy,
and revision surgery for prior bariatric procedures that have either failed mechanically
or which may be causing health issues for individuals. Because weight loss is all
we do, we’re experts in this area of health management. Regular diets don’t work
and lead to failure over and over again. At 'B-lite Clinic' , expect success. In
addition to highly-qualified surgeons, 'B-lite Clinic' employs specially-trained
medical and nursing staff, certified bariatric nurses and allied health all with
a heart to help those that suffer from the disease of obesity. Because we’re passionate
about what we do, we hire people that are passionate, too. We provide a compassionate,
understanding environment for those suffering from obesity or dealing with excess
weight, and we rejoice in every success story in which we have the privilege to
participate. Every one of our employees is committed to helping make your journey
a safe, easy and effective one.
- Why choose 'B-lite Clinic' ?
'B-lite Clinic' is the premier, comprehensive weight management program in Mumbai,
India. We cater not only to the needs of Mumbaites, but our reputation for weight
loss success brings patients from all over India, Mexico, Canada, and as far away
as Dubai.
We’re leaders in the field of weight loss for good reason:
- Our highly-skilled bariatric surgeons who are among some of the most experienced
bariatric surgeons in the nation;
- Every hospital facility where we perform surgery is designated as a bariatric Center
of Excellence, which means that they are specially designed and equipped to meet
the specific needs of weight loss surgery patients;
- Our bariatrician is recognized as a leader nationally in non-surgical weight management;
- Our licensed, certified healthcare professionals and staff are specially trained
in caring for the physical and emotional needs of overweight individuals;
- We provide compassionate care and understanding in caring for individuals struggling
with excess weight;
- The aftercare and support programs will prepare you for long-term success by providing
you with the tools, resources, and education you need to maintain a healthy weight
for life
- Our comprehensive program includes on-site dietitian, psychologist, exercise physiology,
behavior modification classes, vitamin & mineral education and therapy;
- Commitment to long-term follow-up care of every patient.
- How do I know if I qualify for weight loss surgery?
To be eligible, you must have a BMI of 35 or greater without co-morbidities, or
a BMI between 32 and 35 with at least one co-existing co-morbidity related to obesity
(these must be sleep apnea, type 2 diabetes, hypertension or coronary artery disease).
In addition, you must show that you have seriously tried to lose weight in the past;
have no physical, mental or other problems that would make surgery unnecessarily
risky; and be able to participate in your treatment and lifetime follow-up care.
- How old do I have to be to have weight loss surgery?
The American Society for Metabolic and B-lite Clinic Centre for Weight loss and
the National Institutes of Health recommend patients should be at least 18. This
is primarily because younger patients may not have matured physically to the point
that their body can handle the procedure or emotionally to the point that they can
make a decision this important.
- Is there an age limit?
For our program, we will evaluate patients for weight loss surgery up to the age
of 70. This is on a case-by-case basis, and evaluation does not imply that the surgeon
will recommend surgery.
- Can weight loss surgery help me live longer?
Yes. On average, studies show that weight loss surgery increases life expectancy
up to 9.5 years. By comparison, heart bypass surgery increases life expectancy by
about 3.5 years
- How would weight loss affect or improve my current medical problems?
With even minimal weight loss, many medical problems may be improved. Serious medical
problems such as hypertension, type 2 diabetes (adult onset) and sleep apnea may
be improved or, in many cases, completely resolved. It is not necessary to lose
all of your excess weight in order to achieve improvement with many of these medical
conditions. The physicians at 'B-lite Clinic' will consider your individual medical
issues and will discuss how weight loss may positively impact your existing weight-related
medical problems..
- How much weight should I expect to lose with weight loss surgery? What if
I choose to go the non-surgical route for weight loss?
Weight-loss varies from person to person and the amount of weight you lose depends
on several factors. You will need to be committed to your new, healthier lifestyle
and eating habits. Obesity surgery is not a miracle cure. It is not uncommon for
individuals that undergo weight loss surgery to lose 100 pounds or more within the
first six to seven months after their procedure. The type of procedure, your starting
weight, co-morbid conditions, age, and commitment to eating right and exercising
will all play a part in how much weight you will lose after surgery. For individuals
that choose a non-surgical treatment, a weight loss of one to five pounds a week
should be expected. Again, your personal commitment to success will be a huge determining
factor in how much weight you lose. It is very important to work with your physician
to set achievable weight-loss goals from the beginning.
- Why do I need a psychological evaluation before surgery?
There are three reasons you will undergo a psychological evaluation. Firstly, you
will undergo a psychological because an evaluation is required by our program and
may be required by your insurance company in order to receive approval for surgery.
Secondly, we need to assess how well you understand the surgery and its risks, and
whether you have the ability to make the life-long commitment required to maintain
good health. Thirdly, undergoing a psychological evaluation will help identify whether
or not there are any underlying issues that would affect your success after surgery,
such as purging, binging, or other addictive behaviors. Working with our team will
allow you the greatest opportunity for success.
- Does weight loss surgery require frequent visits with my surgeon after surgery?
Follow-up care with your surgeon is very important after any weight loss surgery.
At ‘B-lite Clinic', we see our patients every week after surgery, and then again
within 15days after surgery. We see patients every month thereafter for the first
year after surgery, depending on the procedure. Check with your surgeon as to the
specifics of your follow-up schedule. It is imperative that we draw labs and monitor
your protein, vitamin and mineral intake on a regular basis. All patients are followed
annually for a minimum of five years, but we encourage all of our patients to follow
up with us annually for life. Working closely with your surgeon and our team at
'B-lite Clinic' will help ensure your weight-loss success and will greatly reduce
risks and complications.
- Do you have live support group meetings? Are patients of other surgeons
allowed to attend?
We offer live support group meetings and encourage our patients to attend, as studies
show that patients that actively attend support group meetings and stay plugged
in, achieve long-term success. Our support groups are a “safe place” for you and
we recommend you begin attending right away – even before you’ve had your surgery
– so that you can get a true picture of what lies ahead. Through this, you’ll be
able to remain pin contact with an amazing community of people just like you, who
can offer support, encouragement, and practical advice. Changing behavior is not
easy and we’re sensitive to this fact. At ‘B-lite Clinic' , you will receive the
tools you will need to help you modify your behavior.
- Does weight loss surgery limit any physical activity?
You must follow the instructions of your surgeon regarding return to normal activity.
Generally speaking, after you have been released from your recovery period by your
surgeon, your weight loss procedure will not hamper or restrict any physical activity,
including swimming, aerobics, stretching, strenuous exercise or activities normally
associated with work, such as lifting and climbing. Before returning to normal activities,
you will need to be cleared by your surgeon. A normal recovery period will last
anywhere from two to six weeks.
- How much does the surgery cost if my insurance will not pay for it, or if
I do not have health insurance coverage?
Medical Insurance in India does not cover bariatric Surgeries as of now. We will
speak with you in our office during your consultation about the options available
to you if you decide to self-pay. Costs vary based on procedure.
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Surgery Questions
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- What are some potential complications of weight loss surgery?
Possible complications include, but are not limited to, gallstones, liver problems,
hernia, pouch leak, intestinal blockage, deep vein thrombosis (DVT), pulmonary embolus
(PE), and other risks typically associated with any surgery.
- Will I have to undergo any medical testing prior to surgery or joining the
non-surgical weight loss program?
Whether or not you have to undergo any medical testing will depend on your health
history, your current co-morbid conditions, and other indications of risk. Your
surgeon or bariatrician will discuss any necessary tests required during your consultation.
- Will I be required to lose weight before having weight loss surgery?
For individuals with a body mass index (BMI) greater than 55, weight loss prior
to surgery may be required in order to perform surgery more safely. If this is the
case with you, our bariatric dietitian will work with you one-on-one to establish
a program for weight loss success. In addition, all patients go on a two-week pre-operative
high protein, low carbohydrate diet, as obese individuals tend to have enlarged,
fatty livers. All weight loss surgery procedures require surgical access to specific
areas of the abdomen, and access to these areas may be compromised if a patient
has an enlarged, fatty liver. Putting patients on liquid-diet regimen allows the
liver to shrink, making surgery easier to be performed, and ultimately safer for
you.
- Are staples used in surgery, and if so, what kind are used in the surgery?
No staples are used in the adjustable gastric banding procedure; however, with gastric
bypass and sleeve gastrectomy, staples are used. They are made of stainless steel
or titanium, and are very small.
- Will the staples set off metal detectors?
No
- How big will my stomach pouch be after surgery?
For band and bypass patients, the pouch will hold about one ounce of food after
surgery.
- How long will my weight loss procedure take?
Adjustable gastric banding surgery is generally performed in 30 to 45 minutes; gastric
bypass is generally performed in 45 to 90 minutes; and sleeve gastrectomy is generally
performed in an hour. Revision surgeries require more time and generally run two
to three hours, depending on existing scar tissue and other findings within the
abdomen.
- Will I be able to drive myself home after surgery?
No. We do not allow patients to go home in taxis, buses, or any other form of public
transportation. You will be required to have a responsible adult (at least 18 years
of age) accompany you on the day of surgery and upon your discharge.
- Does weight loss surgery hurt?
All weight loss surgery is performed under general anesthesia and our anesthesiology
team and nursing staff will make sure you are kept comfortable during surgery and
throughout your recovery while in the hospital. Everyone’s goal is that you experience
as little pain as possible, but surgery does involve some inherent pain. We will
send you home with a prescription for pain, but most patients report very little
to no pain after laparoscopic surgery. You may experience discomfort from the gas
(CO2) used to insufflate your belly for the procedure, and walking will help eliminate
this gas from your abdominal cavity.
- Do men and women respond differently to the surgery?
Both respond well, though men tend to lose weight faster than women. We encourage
our patients not to compare their weight loss with the weight loss of others, because
each person’s journey is unique and factors such as age, medical history, co-morbid
and pre-existing conditions, and other factors all play a part in the rate at which
individuals lose weight. The key to successful weight loss is to stay the course,
follow your specific program instructions, make healthy food choices, take your
vitamins and minerals, eat sufficient protein daily, drink plenty of fluids, and
exercise.
- How long do I have to stay in the hospital?
Most patients are discharged home one to three days after surgery.
- Can the adjustable gastric band be removed?
Your band is designed to be permanent and is not meant to be removed; however, in
rare circumstances such as a band slippage, it may need to be removed. If removal
is necessary, it can be done laparoscopically, usually as an outpatient procedure.
Studies show that the stomach typically returns to its original, normal shape once
a gastric band is removed.
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Life After Surgery
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- Why is it important to walk after surgery?
The most serious life-threatening complication that can occur after surgery in a
morbidly obese individual is in developing deep vein thrombosis (DVT) or blood clot,
which can lead to a pulmonary embolism (PE, a sudden blockage in a lung artery).
A clot can form in the leg and travel to the lung, resulting in death. During surgery,
you will be prepped with special compression devices on your feet and lower legs
that will help with circulation so that blood is not as likely to pool in your extremities.
These compression devices will remain on your feet and legs after surgery and you
will be required to keep them on during your hospital stay any time you are not
up and walking. Because keeping your circulation moving is so important after surgery,
you will be required to get up and walk shortly after surgery. In addition, you’ll
be required to walk every hour during waking hours while in the hospital and at
home, so that your risk of developing a blood clot is reduced. While it will be
uncomfortable to push yourself to walk at first, it is vitally important to minimizing
your risk of this severe complication. Signs and symptoms of a PE include unexplained
shortness of breath, chest pain, anxiety, and coughing. Signs and symptoms of a
DVT include swelling in the leg, pain or tenderness in the leg, increased warmth
in the area of the leg, and red or discolored skin on the affected leg. If you experience
any of these signs and symptoms while in the hospital, notify your nurse immediately.
If you experience any of these signs and symptoms while at home, you should call
us on 9821350957 and seek immediate medical attention. We take this risk extremely
seriously and expect you to walk regularly for many months after surgery to reduce
your risk of this complication.
- When can I return to work?
Most people return to work within 7 to 14 days after weight loss surgery.
- When can I return to my normal activities?
Your surgeon will determine when it is okay for you to return to your normal activities,
but most people return to their normal activities within 14 days to six weeks after
surgery. You will not be permitted to lift anything over 10 pounds for the first
four to six weeks after surgery.
- What kind of exercise regimen should I follow after surgery?
Exercise is an important part of your recovery. Patients begin walking the day of
their procedure – they walk a little more the next day, a little more the
day after that, and so on. As you get stronger, you should aim to reach 30 to 60
minutes of aerobic exercise every day.
- Can I take medications after weight loss surgery?
At first, your doctor may recommend taking pills in liquid or crushed form. After
the first four weeks, most pills and capsules should easily pass through the stomach
pouch. With a gastric bypass, you should not take extended release medications after
your procedure. It is important that you work with your primary care physician to
adjust your medications after weight loss surgery, including medications for diabetes,
as many patients are able to leave the hospital on very little to no diabetes medications.
In addition, hypertension medication will need to be adjusted frequently with rapid
weight loss.
- Are there any limitations on the medicines I can take?
In general, diuretics and some over-the-counter medications should be avoided. Some
over-the-counter medications can cause ulcers in the small stomach and should be
avoided (ibuprofen, Advil, Aleve, Motrin). Always consult with your bariatric surgeon
about the medications you are taking or wish to begin taking.
- When can I resume sexual activity?
You may resume sexual activity when you feel that you are able to do so.
- Can I continue to smoke after obesity surgery?
No. Smoking increases the potential for lung problems before surgery, stalls the
healing process, promotes infection and interferes with the blood flow to tissues
that are healing. In addition, smoking significantly increases your chances for
developing ulcers.
- Should I worry about losing too much weight?
No; however, if you are concerned about your weight loss, talk with your bariatric
surgeon or our dietitian.
- Will I lose my hair after surgery?
Some patients experience thinning of the hair, typically in the first four to eight
months after surgery. In most cases, it comes back naturally. You can help prevent
hair loss by getting enough protein with meals and by drinking sufficient fluids
during the day. You should consume 80 grams of protein daily, and 64 oz. of non-carbonated,
sugar-free, decaffeinated liquids daily.
- When can I start driving again?
You should wait to start driving until your doctor clears you. Usually you’ll be
able to drive again one week after surgery. You may not drive as long as you are
on prescription pain medication.
- Can I try to get pregnant after weight loss surgery?
Many of our patients have weight loss surgery because of infertility issues. Because
estrogen is released in fat cells, losing excess weight allows many women to become
fertile and achieve pregnancy. To ensure you maximize your weight loss and that
you have a healthy pregnancy, we want you to wait at least 12 to 18 months after
weight loss surgery before trying to conceive. During this time period, we strongly
recommend that you use two forms of birth control to avoid becoming pregnant. Weight-loss
during pregnancy can be dangerous to the health of your developing baby. Once your
bariatric surgeon has agreed that you are healthy enough to carry a pregnancy to
term and that your weight loss has stabilized, you may begin trying to conceive.
If you are an adjustable gastric band patient, if you become pregnant, saline will
be removed from your band; the band will be left in place and can be re-inflated
via the port after delivery.
- Will I need plastic surgery for the removal of excess skin after I have
lost a significant amount of weight?
Every person’s body is different. Skin elasticity is based on many factors including
genetics, age, whether or not you have carried a pregnancy (or multiple pregnancies),
whether or not you have ever smoked, and your overall general level of health. As
a general rule, plastic surgery should not be considered for at least 18 months
after your weight loss surgery so that you give your body time to settle in to its
new shape and you maximize your weight loss. To maximize the benefits of plastic
surgery, we recommend that you be within ten pounds of your ideal body weight and
your weight has stabilized for at least six months.
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Nutrition, Food & Eating After Surgery
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- How will I eat after surgery?
Right after surgery, you will only be consuming liquids. We will instruct and educate
you on the dietary phases, including when to progress to pureed and soft foods,
and then when to progress to solid foods. There will be some foods you will not
be able to tolerate after weight loss surgery. Our dietitian will review these with
you so that you minimize and/or avoid difficulties with your diet. Of course, in
order to be successful, you must make changes in what you eat, so that every bite
is a nutritious, healthy bite. We will guide you along the way as you progress,
and our nutrition classes will teach you how to read labels, cook healthy, make
better choices, and achieve optimum nutrition.
- Will I lose my appetite with weight loss surgery? If so, when will my appetite
return?
Every individual is different. Some people experience a return in appetite shortly
after surgery, while for others, it takes longer. Usually, hunger returns three
to six months after surgery.
- How much water or fluids should I drink daily?
Initially, you should consume 32 to 48 oz. per day. At two months after surgery,
you should increase your intake to 64 oz. of sugar-free, non-carbonated, caffeine-free
fluids per day. Drink it slowly, in small sips.
- How much protein do I need every day?
You need to eat 80 grams of protein daily to maintain good health and proper muscle
mass. We want you to continue your appointments with our registered dietitian for
the first year after surgery. We need to follow how you’re doing to ensure the healthiest
outcome for you.
- What are the best sources of protein?
Sprouts, Soya, Tofu, Low-fat cheese, Cottage Cheese, Chicken and Grilled Fishes
are just some of the protein-rich foods you should enjoy.
- Can I have milk products?
Yes, but keep in mind that every individual is different, and you’ll need to see
how your new system reacts to dairy. There are many lactose-free milk products available
now at your local supermarket.
- After surgery, do I have to cut back on my salt intake?
Not unless your doctor tells you to watch your intake.
- Can I still eat spicy foods?
Yes
- Can I drink alcohol after weight loss surgery?
We recommend waiting one year after surgery before consuming alcohol. Then, with
your surgeon’s approval, you can enjoy a glass of wine or a small cocktail.
Remember to be careful because even the smallest amounts of alcohol will affect
you differently after obesity surgery.
- Will I need to take vitamins and mineral supplements daily for life?
Yes. The following will be taken daily after weight loss surgery: multi-vitamin
(twice daily), Vitamin D, calcium, B vitamins, iron, and possibly others based on
your routine lab results. Vitamins and mineral supplementation is non-negotiable
after weight loss surgery. You may purchase your supplements in our office or by
contacting our dietician.
- What is “dumping syndrome”?
It is a condition that occurs in gastric bypass patients when sugar (also known
as simple carbohydrates) are “dumped” too quickly into the small intestine.
You may experience cramping, diarrhea, rapid heartbeat, sweating, nausea, fainting,
weakness, and/or headache. Dumping syndrome may last up to an hour; often, the only
way to ease the discomfort is to lie down and let it pass. Dumping syndrome may
also reduce blood pressure because of the rapid increase in blood sugar that causes
your body to release too much insulin.
- How can I avoid this condition?
Avoid sugar and other simple carbohydrates.
- Where can I purchase the highest quality nutritional supplements specifically
designed to meet the needs of weight loss surgery patients?
'B-lite Clinic' is stocked with nutritional supplements specifically designed to
meet the micro-nutritional needs of bariatric patients.
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Obesity is a growing
epidemic of global proportions. There are more than 1 billion adults overweight
and at least 300 million of them clinically obese. And this is surely a major contributor
to the global burden of chronic disease and disability. Obesity is not about being
overweight anymore; it is considered a disease now!
